Estimating the contribution of musculoskeletal impairments to altered gait kinematics in children with cerebral palsy using predictive simulations.

The study included only eight participants, which is a very small sample size that limits generalizability. The models did not account for motor control impairments like spasticity or reduced selective muscle control, which are known to affect gait in cerebral palsy. Foot and tibial deformities were not modeled, despite being common in this population and likely contributing to gait deviations. The translation of clinical Manual Muscle Testing scores into computer model strength parameters involved assumptions that may not accurately reflect true muscle force. The study was exploratory and did not correct for multiple statistical comparisons.

Funding was provided by KU Leuven and the Fonds Wetenschappelijk Onderzoek.

Do not interpret the limited explanatory power of the models as evidence that musculoskeletal impairments are unimportant. The models excluded motor control issues and foot deformities, so the unexplained variance likely reflects these missing factors rather than a lack of contribution from the impairments that were modeled.